科研之友
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摘要
Background Epidemiology data regarding hidradenitis suppurativa (HS) are conflicting and prevalence estimates vary 80- fold, from 0.05% in a population- based study to 4%. Objectives To assess the hypothesis that previous population- based studies underestimated true HS prevalence by missing undiagnosed cases. Methods We performed a population- based observational and case- control study using the U. K. Clinical Practice Research Datalink (CPRD) linked to hospital episode statistics data. Physician- diagnosed cases in the CPRD were identified from specific Read codes. Algorithms identified unrecognized ` proxy' cases, with at least five Read code records for boils in flexural skin sites. Validation of proxy cases was undertaken with general practitioner (GP) questionnaires to confirm criteria- diagnosed cases. A case- control study assessed disease associations. Results On 30 June 2013, 23 353 physician- diagnosed HS cases were documented in 4 364 308 research- standard records. In total, 68 890 proxy cases were identified, reduced to 10 146 criteria- diagnosed cases after validation, extrapolated from 107 completed questionnaires (61% return rate). Overall point prevalence was 0.77% [95% confidence interval (CI) 0.76- 0.78%]. An additional 18 417 cases had a history of one to four flexural skin boils. In physician- diagnosed cases, odds ratios (ORs) for current smoker and obesity (body mass index > 30 kg m- 2) were 3.61 (95% CI 3.44- 3.79) and 3.29 (95% CI 3.14- 3.45). HS was associated with type 2 diabetes, Crohn disease, hyperlipidaemia, acne and depression, and not associated with ulcerative colitis or polycystic ovary syndrome. Conclusions Contrary to results of previous population- based studies, HS is relatively common, with a U. K. prevalence of 0.77%, one- third being unrecognized, criteria- diagnosed cases using the most stringent disease definition. If individuals with probable cases are included, HS prevalence rises to 1.19%.
- 出版日期2018-4
